DEBATE PACK Number 0057, 22 April 2021 That this House has considered e-petition By Aaron Kulakiewicz Melissa Macdonald 259892, relating to air ambulance funding Contents

1. Background 2 Summary 1.1 List of UK air ambulances and their locations 3 A Westminster Hall debate on the e-petition 259892, relating to air ambulance funding has been scheduled for Monday 26 April 2021 from 9.30-11.00am. The 2. Funding and operational subject for this debate was determined by the Petitions Committee. models 5 2.1 Public funding for air ambulance services in England 7 2.2 Air ambulances and devolution 8 3. Key policy issues 10 3.1 Impact of Covid-19 pandemic on funding 10 4. Parliamentary Material 13 4.1 Debates 13 4.2 Parliamentary Questions 13 5. News Articles and Press Releases 15 5.1 News Articles 15 5.2 Press Releases 15 6. Further Reading 16 6.1 Reports 16

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1. Background

The petition ‘The Air Ambulances to be government funded’ closed on 6 November 2019 and received 134,143 signatures.1 The petition set out the following: The air ambulances that operate around the UK cost around £12,000 per day to run and maintain, and are mainly funded through charity organisations. This petition is to ask the Government to fully fund the air ambulances through the emergency services.2 The Government responded to the petition on 3 July 2019: Air ambulance services are not NHS funded and are provided by 18 charitable organisations across England, with the majority of their resources supported by their own fundraising activities. We recognise that Air Ambulances provide a valuable service, including to remote locations through both delivery of a specialist team to an incident, and patient transportation back to treatment centres. Air Ambulance crews treat people in critical conditions who rely on urgent treatment before they can reach a hospital. They support the wider NHS emergency response on the ground, ensuring patients get specialised care in both urban settings and hard-to-reach rural areas. Many Ambulance Trusts across England currently work in partnership with Air Ambulance providers from the commercial and charity sectors to deliver services. NHS England works closely with Air Ambulance charities at a local level as part of their considerations of the urgent and emergency care mix in different areas of the country. The NHS Long Term Plan will improve emergency care for all patients, including those treated by Air Ambulances charities. Since April 2002, the NHS has been instructed to provide and fund the cost of some staff on a number of Air Ambulances. However, as decisions on the provision of services for the safe delivery of care are best made at a local level, the level of funding support varies from charity to charity; some charities fully fund their own medical staff on their ambulance, whilst others receive more NHS funding support. Both the type of service provided, and the level of funding support will be driven by local issues such as geography and demography. There are high capital and revenue costs associated with helicopter emergency medical services, including purchasing and maintaining helicopter provision. However, we have made provisions for substantial funding support in this and previous budgets to help ensure that Air Ambulance charities are equipped to provide lifesaving care to patients in need. This year, Air Ambulance charities across England have been invited to bid for a share of £10 million capital funding to invest in new equipment and upgrade facilities to support them in delivering services to patients across England.

1 Parliament.uk, Petitions: The Air Ambulances to be government funded (259892) 2 Parliament.uk, Petitions: The Air Ambulances to be government funded (259892) That this House has considered e-petition 259892, relating to air ambulance funding 3

The All-Party Parliamentary Group for Air Ambulances (APPGAA) is a group of MPs and peers dedicated to highlighting issues and opportunities around Air Ambulance services with policy makers. We will continue to work closely with the sector to ensure patients continue to benefit from these services. Essential public donations, combined with periodic funding contributions from the Government, will ensure these charities can have world-class facilities to match their reputation for world-class care, through a patient-centred approach which works for the population they serve.3 Air Ambulances UK represents the UK’s 21 air ambulance charities and wider air ambulance sector. The organisation estimates that “every day across the UK air ambulance charities collectively undertake around 70 lifesaving missions” and approximately 25,000 a year.4

1.1 List of UK air ambulances and their locations There are 22 air ambulance organisations in the UK, 21 of which are charitable organisations: 1 Air Ambulance Northern Ireland (All of Northern Ireland. Says they can reach anywhere in the province in approximately 25-30 minutes) 2 Air Ambulance (Cornwall & . Average response time of 12 minutes to get to an incident) 3 Air Ambulance (Devon) 4 and Air Ambulance (Dorset & Somerset) 5 East Anglian Air Ambulance (, , & ) 6 & Herts Air Ambulance (Essex, & surrounding areas) 7 Great North Air Ambulance (, the North East, & . 2 staffed bases at Langwathby, near Penrith, and Teesside International Airport, near Darlington) 8 Great Western Air Ambulance (, Bath & North East Somerset, , , ) 9 and Air Ambulance (Hampshire & Isle of Wight) 10 , and Sussex Air Ambulance Trust (Kent, Surrey & Sussex, based in Rochester) 11 and Air Ambulance (Lincolnshire & Nottinghamshire) 12 London Air Ambulance (London – within the M25) 13 Air Ambulance (Cambridgeshire, Bedfordshire and across the ) 14 Air Ambulance (Gloucestershire, , , , the and . This

3 Parliament.uk, Petitions: The Air Ambulances to be government funded (259892) 4 Air Ambulances UK, Saving lives: Top 10 Facts, Accessed on 21 April 2021 4 Number 0057, 22 April 2021

constitutes the largest air ambulance operating region in the UK. The charity also provides secondary cover to surrounding areas, such as and Mid Wales.) 15 (Cumbria, , Greater , , . Based in and Barton) 16 Scotland Charity Air Ambulance (All of Scotland, based in Perth & . Say they can reach 90% of Scotland’s population within 25 minutes) 17 Scottish Ambulance Service (Not a charity – part of the NHS. 2 helicopters in and Inverness, and 2 planes in Aberdeen and Glasgow, which are fully funded by the NHS) 18 Thames Valley Air Ambulance (, & ) 19 The Air Ambulance Service (Consists of 2 local air ambulance services; , & air ambulance and Warwickshire & air ambulance. And also, the Children’s Air Ambulance, which is UK wide) 20 (All of Wales. 4 helicopters based in Caernarfon, Llanelli, Welshpool and . Say they can reach anyone in Wales in 20 minutes. Their website also states they are the “UK’s largest air ambulance operation”) 21 Air Ambulance (Wiltshire and surrounding area) 22 (Yorkshire. 2 helicopters; 1 based near , and 1 near , North Yorkshire) The air ambulance organisations work in conjunction with the NHS ambulance trusts. There are 13 NHS ambulance trusts across the UK compared with 21 air ambulance charities.

That this House has considered e-petition 259892, relating to air ambulance funding 5

2. Funding and operational models

The governance structure of air ambulance organisations can be complex and varies across the UK. Most UK emergency air ambulances are funded by charitable organisations, with medical staff seconded from the local NHS trust. However, some charities employ their own medical staff. In addition, some air ambulance charities own their own helicopters and employ their own pilots, whereas others have contracts in place to lease helicopters. Increasingly, air ambulance services have been purchasing their own helicopters. For instance, service recently bought its first helicopter.5 Scotland is the only part of the UK to have NHS funded air ambulance provision. Factors such as employment of medical staff determine the information published about the air ambulance charity. For example, if the organisation employs its own medical staff, it must register with the Care Quality Commission (CQC). The CQC report ‘A fresh start for the regulation of ambulance services’ provides some further detail: Working in support of NHS ambulance services is a network of air ambulances funded by public charitable donations that has been established across England. […] NHS ambulance services are able to despatch these aircraft to transport a doctor and/or paramedic to the scene of an incident over greater distances or to remote areas. Often this is much quicker than could be achieved by a land ambulance. Sometimes a land response will arrive first with additional care being provided by the air response. Dependent upon the location and condition of each patient the air ambulance will either fly patients to hospital or care for patients until the arrival of a road ambulance. Arrangements for the provision of the helicopter, pilot and clinical crew can vary between different charities. The majority of air ambulance services fall outside of the scope for CQC registration because the air operator (the provider of the aircraft) is regulated by the Civil Aviation Authority (CAA) and the staffing and governance of the service is a matter for the host ambulance service. However, in a small number of cases, where the clinical staffing and governance of the service is the responsibility of the private or voluntary provider, the provider requires registration with CQC.6 In the case of Dorset and Somerset Air Ambulance, they note they are tasked “as part of the normal ‘999’ emergency process by a dedicated Helicopter Emergency Medical Service (HEMS) desk located at Ambulance Control (paid for by the South West Air Ambulance Charities).”7 The Association of Air Ambulances published the ‘Framework for a high performing air ambulance service’ in November 2013 which provides some information about the operational models of air ambulance services. The framework stated:

5 Cornish Stuff, New Air Ambulance takes to the skies, 1 April 2020 6 CQC, A fresh start for the regulation of ambulance services, April 2014 7 Dorset and Somerset Air Ambulance, About us, Accessed on 21 April 2021 6 Number 0057, 22 April 2021

There are a number of different funding and operational models of air ambulance services throughout the UK. The most dominant model is where charities are established as “Owner/Operator” charities. These charities provide the air ambulance services with ambulance service regions. For this arrangement to work there should be a Service Level or Operational agreement; this can be a formal contract, with penalties, between the charity and the participating NHS Ambulance Service(s). An annual review of the agreement should be taken.8 As set out above, the vast majority of air ambulance services operate as separate independent charities. However, in the case of The Air Ambulance Service, the charity provides two local air ambulance services (Warwickshire & Northamptonshire Air Ambulance and Derbyshire, Leicestershire & Rutland Air Ambulance) alongside the Children’s Air Ambulance, which is UK wide. The Scottish Ambulance Service also operates its own air ambulance service, which is not a charitable organisation. The Association of Air Ambulances’ ‘Framework for a high performing air ambulance service’ provides detailed information regarding governance arrangements. Dorset & Somerset Air Ambulance provide the following information about their funding arrangements: We receive no direct funding from the Government or the National Lottery and rely on the generosity of the public for support. Our operational costs are over £4 million a year and the approximate cost per mission is £3,000.9 Hampshire & Isle of Wight Air Ambulance published an infographic outlining their 2018/19 income streams which indicates most of their income came from “Legacies & In Memoriam” (£627,000) followed by “Community” (£558,000), and “Committed Giving” (£530,000).10 Whilst fundraising events typically take place all year round, there is a national ‘Air Ambulance Week’ which takes place in the second week of September each year to raise awareness and raise funds.11 The next Air Ambulance Week is scheduled to take place from 6 – 10 September 2021.12 London Air Ambulance have also published information regarding where their funding comes from: In 2019/20 we raised almost £14m (consolidated income) from our supporters and partners. With thanks to the generosity of supporters like you, income from individuals and our Lottery increased by 18%. Income from events almost doubled from £488k to £906k due to our successful 30th Anniversary Gala.13 The London Air Ambulance webpage ‘How we are funded’ also provides information on what the funding is spent on:

8 Association of Air Ambulances, Framework for a high performing air ambulance service, November 2013 9 Dorset & Somerset Air Ambulance, About us 10 Hampshire & Isle of Wight Air Ambulance, Financial information 11 Air Ambulances UK, Air Ambulance Week 2020 12 , Air Ambulance Week 2021 13 London’s Air Ambulance Charity, How we are funded That this House has considered e-petition 259892, relating to air ambulance funding 7

It costs approximately £10.5 million (consolidated costs) to provide London with an advanced trauma care service 24 hour a day, 7 days a week. Almost half of this cost was spent on directly funding our charitable activities. For every pound of spending in 2019/20, 47p was spent delivering our lifesaving service and 53p went towards fundraising.14

2.1 Public funding for air ambulance services in England During a Westminster Hall debate on Air Ambulances on 27 February 2008, the issue of NHS funding of air ambulance clinical staff was raised by Dr Ian Gibson, who was then MP for Norwich North: I do not wish to go through a freedom of information document that the Department has provided me with, but it includes a column showing whether, in various parts of the UK, the local NHS trust pays for the full cost of clinical staff. The answers are yes, yes, no, yes, no, yes, yes, yes, yes, no and yes. A column on whether they pay for drugs reads yes, yes, yes, no, yes, yes, yes, no, no, yes. You get the picture, Mr. Bercow—the situation varies depending on the trust involved.15 More recently a Parliamentary Question was asked in March 2017 regarding public funding for air ambulances, and the following response was provided: Air ambulance services are independent charities, and do not receive direct funding from the Department of Health or NHS England. Local air ambulance charities may receive resources from ambulance trusts or other National Health Service bodies but information on these NHS resources is not held centrally.16 Some of the air ambulance services make clear on their websites that they receive funding from their NHS partners, such as London Air Ambulance: We work closely with the NHS and receive some funding from our NHS partners, but we are not an NHS organisation.17 A press release from the Department of Health and Social Care on 19 July 2019 announced that £10 million had been awarded to 9 air ambulance charities: Nine air ambulance charities across England will receive a share of £10 million funding. The 9 charities that will receive funding are: • East Anglian Air Ambulance • Cornwall Air Ambulance Trust • London’s Air Ambulance • Essex and Herts Air Ambulance Trust

14 London’s Air Ambulance Charity, How we are funded 15 WH Deb, Air Ambulances, 27 February 2008 16 Written questions, answers and statements, Air Ambulance Services, Answered on 24 April 2017 17 London’s Air Ambulance Charity, How we are funded 8 Number 0057, 22 April 2021

• Lincolnshire and Nottinghamshire Air Ambulance Charitable Trust • Great Western Air Ambulance Charity • Devon Air Ambulance Trust • MAGPAS Air Ambulance • Charity The funding means air ambulance charities will benefit from new equipment and improved facilities, including: ─ modernised operational facilities at 7 airbases ─ a new state-of-the-art helicopter for Cornwall Air Ambulance Trust ─ 7 critical care cars with medical equipment ─ immersive interactive training suites to better prepare crews for challenging conditions18 The press release explains that the call for bids for funding was launched in February 2019: This invited the 18 air ambulance charities across England to submit bids of up to £2 million for projects to improve their facilities. Fourteen applications were received and 9 were successful. The applications went through several stages of assessment to select bids which were deliverable and offered the best value for money.19

2.2 Air ambulances and devolution Wales Air Ambulance have published the following summary of how they operate: A unique Third Sector-Public Sector partnership between the Charity and NHS Wales has resulted in the creation of the consultant-led Emergency Medical Retrieval and Transfer Service (EMRTS Cymru), more commonly known as the ‘Welsh Flying Medics’. WAA now provides pioneering pre-hospital critical and emergency medical care across Wales – taking the emergency room to the patient.20 Wales Air Ambulance also has a specialist division, Children’s Wales Air Ambulance which provides “expert care and transport required for paediatric and neonatal patients.”21 In Northern Ireland, Air Ambulance Northern Ireland note: The Air Ambulance Northern Ireland Charity has a unique partnership with Northern Ireland Ambulance Service (NIAS) to deliver the Helicopter Emergency Medical Service. Our Memorandum of Understanding enables the 15 doctors and 7 paramedics provided by NIAS to fly on board its aircraft 7 days per week bringing advanced

18 Department of Health and Social Care, £10 million awarded to 9 air ambulance charities, 19 July 2019 19 Department of Health and Social Care, £10 million awarded to 9 air ambulance charities, 19 July 2019 20 Wales Air Ambulance, 2018 confirmed as busiest ever year for Wales Air Ambulance 21 Wales Air Ambulance, Children’s Wales Air Ambulance That this House has considered e-petition 259892, relating to air ambulance funding 9

clinical interventions, treatments and care to patients before reaching hospital. NIAS has responsibility for all aspects of clinical governance including the provision of a rapid response vehicle at the base.22 On 24 March 2021 the Belfast Telegraph reported that the Northern Ireland Air Ambulance would receive £1 million in funding from the Department of Health “to assist Air Ambulance NI with the challenges they are currently facing and assure the ongoing success of the funding partnership that delivers this valuable service”.23 Scotland is the only part of the UK with NHS air ambulance provision. The Scottish Ambulance Service has 2 helicopters and 2 planes which are fully funded by the NHS. The Scottish Ambulance Service makes clear it works closely with the Scotland Charity Air Ambulance. In 2019/20, 3,732 air ambulance missions were undertaken by the Scottish Ambulance Service.24 The ‘Annual Report and Accounts for year ended 31 March 2020’ includes information on the air ambulance costs.

22 Air Ambulance Northern Ireland, About, (Accessed on 21 April 2021) 23 Belfast Telegraph, £1 million boost for Northern Ireland Air Ambulance service, 24 March 2021 24 Scottish Ambulance Service, Annual Report and Accounts for year ended 31 March 2020, page 7 10 Number 0057, 22 April 2021

3. Key policy issues

Prior to the pandemic, Air Ambulances UK set out the top four policy issues facing its members: 1. Emergency Services Mobile Communications Programme In 2016, it was planned that the replacement for all the emergency services radio networks would be launched to replace the current Airwave system that allows air to ground and ground to ground communications between emergency services. To date the project has been delayed with the transition of services estimated to be completed in late 2022 2. Helicopter Landing Sites Access to Helicopter Landing Facilities at Specialist Treatment Centres is inconsistent across the UK. Additionally, the introduction of night air operations realises the need for 24/7 accessibility to more approved night landing sites 3. Patient Data/Outcome Information and Risk Management support Requirements of a formal and funded national system to improve and standardise key areas of data collation to support with improving and enhancing patient care and risk management 4. Flight Time Limitations Flight Time Limitations (FTL’s) are being debated by EASA and the CAA, with the potential of a set maximum number of working hours being imposed on HEMS Crew Members. During an All Party Parliamentary Group for Air Ambulances25 reception on 5 July 2018 a number of the above issues were raised. For example, it was noted “the NHS used to include a requirement for helipad infrastructure in its building note for hospitals, but the requirement was later dropped.”26 3.1 Impact of Covid-19 pandemic on funding Yorkshire Air Ambulance released the following statement following the first wave of the Covid-19 pandemic: It is no secret that we have seen a huge downturn in fundraising incomes and activities in the last couple of weeks. A calendar packed full of summer events and activities has virtually been wiped out, with an estimated loss of income for this period alone being in the region of £400,000 plus.27 A ‘Statement from the Yorkshire Air Ambulance regarding the updated impact of Covid-19 on the charity’ was subsequently published on 29 October 2020 which explained the financial impact was larger than originally anticipated:

25 The APPG for Air Ambulances is no longer listed on the Register of All-Party Parliamentary Groups (Accessed on 21 April 2021) 26 Association of Air Ambulances, All Party Praise for UK Air Ambulances, 5 July 2018 27 Yorkshire Air Ambulance, Covid-19 update 30/03/2020 That this House has considered e-petition 259892, relating to air ambulance funding 11

As COVID-19 and its impact continues to progress into the autumn and winter months, fundraising activity is still significantly decreased, mainly because larger gatherings are still prohibited. As a result, the life-saving emergency service Charity has seen a much larger hit to their financial income than initially predicted, and as such, now estimate that fundraising deficit for the Charity stands in the region of £1.2M.28 Similarly, Cornwall Air Ambulance put out an urgent appeal for funds following the first wave and their website currently states they are set to lose £1 million by the end of the year: Cornwall Air Ambulance is set to lose a massive £1million by the end of the year due to the earlier closure of its charity shops, cancellation of community fundraising and events. This could start to have huge consequences for the charity and the people of Cornwall and the Isles of Scilly. This sustained lack of fundraising income could significantly impact the service we provide. Cornwall Air Ambulance is an independent charity, and although we have NHS paramedics in the team, the charity is not eligible for the millions of pounds raised for the NHS.29 Devon Air Ambulance Trust raised concerns about the impact of social distancing requirements and PPE usage in air ambulances in an article ‘Challenging times require clarity in decision-making’: It was clear to us that without the ability to wear adequate PPE in flight, our crews would potentially be exposed to an increased risk of contracting Coronavirus. Furthermore, with an incubation period of around 2-weeks, an infected member of staff could potentially infect many patients, other staff and other healthcare professionals during that period. Devon Air Ambulance resumed flying but had to install the following protective measures: A new separation screen has been installed between the front and rear sections of the aircraft, which partitions-off the pilot cockpit from the patient treatment/paramedic area. Our aircrew will also now be able to use newly designed throat microphones when they need to wear Level 3 PPE respirator masks in-flight which will improve internal and external communication. Lastly, a new bracket has been designed which will enable a full-face visor to be worn on our aviation safety helmets. This will provide the ability for our clinicians to wear the required Level 3 PPE when carrying out medical procedures which carry a greater risk of transmitting Coronavirus.30 In recent months, Air Ambulances UK have published articles setting out the challenges faced by air ambulance services across the UK. For example, ‘Urgent fundraising appeal for London’s Air Ambulance Charity this Christmas’ and ‘Air Ambulance reveals 24/7 plans are still a reality despite challenging year and forecast £1.7m loss over 12 months’. On 22 May 2020, the Government announced a £6 million Covid-19 funding grant for Air Ambulances UK to “continue to provide life-saving services

28 Yorkshire Air Ambulance, Statement from the Yorkshire Air Ambulance regarding the updated impact of Covid-19 on the charity, 29 October 2020 29 Cornwall Air Ambulance, Future lives depend on you, Accessed on 21 April 2021 30 Devon Air Ambulance Trust, Devon Air Ambulance resumes flying, 6 May 2020 12 Number 0057, 22 April 2021

throughout the outbreak”.31 This funding was provided as part of £22 million awarded by the Government to life-saving health charities during the pandemic.32

31 GOV.UK, Department of Health and Social Care, £22 million awarded to life-saving health charities during virus outbreak, 22 May 2020 32 GOV.UK, Department of Health and Social Care, £22 million awarded to life-saving health charities during virus outbreak, 22 May 2020 That this House has considered e-petition 259892, relating to air ambulance funding 13

4. Parliamentary Material 4.1 Debates Air Ambulances 27 Feb 2008 | House of Commons | Westminster Hall | 472 c304-11WH Westminster hall adjournment debate on air ambulances in the NHS.

4.2 Parliamentary Questions Air Ambulance Services: Coronavirus 21 Apr 2020 | 32191 Asked by: Rosie Duffield To ask the Secretary of State for Health and Social Care, what plans his Department has to ensure the continued operation of air ambulances during the covid-19 outbreak. Answering member: Edward Argar | Department: Department of Health and Social Care (DHSC) The Department continues to engage with the air ambulance sector via Air Ambulances UK, the national organisation for the ’s air ambulance charities. The charities have been asked to provide an assessment of the operations and fundraising impact of COVID-19 to give a clear national picture of their needs. Further to this, any support required by air ambulance charities is being considered by the National Ambulance Coordination Centre as part of their role in supporting voluntary sector deployment as appropriate during the COVID-19 pandemic. Air ambulances are self-funded, but the Government has previously provided one-off grants to support capital projects, such as building or extending airbases and helipads, and purchasing equipment, cars and aircraft. Air Ambulance Services: Finance 22 Oct 2019 | 561 Asked by: Julian Sturdy To ask the Secretary of State for Health and Social Care, what funding he is allocating to air ambulance services. Answering member: Edward Argar | Department: DHSC The Autumn 2018 Budget announced £10 million of capital funding to support air ambulance services. This funding has been allocated to nine charities across England with successful bids which represented the best value for money and positive patient impact. The allocation will fund upgrades to seven operational airbases, including training facilities and fundraising headquarters. There were also three successful bids for critical care cars and medical equipment, and one bid for a new helicopter. Air Ambulance Services: Finance 14 Number 0057, 22 April 2021

04 Sep 2019 | 282351 Asked by: Dan Jarvis To ask the Secretary of State for Health and Social Care, how many applications from air ambulance charities his Department received for the air ambulance capital fund. Answering member: Chris Skidmore | Department: DHSC As part of the Autumn 2018 Budget, £10 million capital funding was allocated for air ambulance services in England. A call for bids for charities to apply for funding was launched by the Department and 14 applications were received. Nine applications were successful, and these air ambulance charities will receive a share of £10 million funding as per the table below:

Charity Amount

East Anglian Air Ambulance £790,313

Cornwall Air Ambulance Trust £1,397,700

London's Air Ambulance £1,393,552

Essex and Herts Air Ambulance Trust £1,500,000

Lincolnshire and Nottinghamshire Air Ambulance Charitable £1,818,200 Trust

Great Western Air Ambulance Charity £267,659

Devon Air Ambulance Trust £226,061

MAGPAS Air Ambulance £1,340,493

Midlands Air Ambulance Charity £1,266,022

Air Ambulance Services 24 Apr 2017 | 69895 Asked by: Byron Davies To ask the Secretary of State for Health, how much public funding was provided to air ambulance organisations in each of the last five years. Answering member: Mr Philip Dunne | Department: Department of Health Air ambulance services are independent charities, and do not receive direct funding from the Department of Health or NHS England. Local air ambulance charities may receive resources from ambulance trusts or other National Health Service bodies but information on these NHS resources is not held centrally. That this House has considered e-petition 259892, relating to air ambulance funding 15

5. News Articles and Press Releases 5.1 News Articles The following is a selection of news and media articles relevant to this debate. Please note: the Library is not responsible for either the views or the accuracy of external content. £1 million boost for Northern Ireland Air Ambulance service Belfast Telegraph 24 March 2021 North West Air Ambulance launches urgent appeal for funding after Covid sees revenue dramatically drop ITV News 2 March 2021 Coronavirus: Yorkshire Air Ambulance funding hit BBC 30 November 2020 Air Ambulance reveals 24/7 plans are still a reality despite challenging year and forecast £1.7m loss over 12 months Air Ambulances UK 30 November 2020 Drop in donations - concerns raised as Air Ambulance Week launches in the UK Air Med & Rescue 7 September 2020 New Air Ambulance takes to the skies Cornish Stuff 1 April 2020

5.2 Press Releases £22 million awarded to life-saving health charities during virus outbreak Department of Health and Social Care 22 May 2020 £10 million awarded to 9 air ambulance charities Department of Health and Social Care 19 July 2019 16 Number 0057, 22 April 2021

6. Further Reading 6.1 Reports Care Quality Commission, A fresh start for the regulation of ambulance services, 2014

Association of Air Ambulances, Framework for a High Performing Air Ambulance Service 2013, November 2013

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